Health Plan of San Joaquin provider Alerts

Pediatric Palliative Care

Date: July 11, 2019 To: Health Plan of San Joaquin (HPSJ) Providers From: HPSJ Medical Management Department Subject: Pediatric Palliative Care Business: Medi-Cal Medi-Cal plans are required to provide palliative care services to their pediatric members (APL 18-020). A member under 21 years of age can receive palliative care and hospice services concurrently with curative […]

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Important Information: HEDIS Tip Sheet, G0447

Date: July 11, 2019 To: All Health Plan of San Joaquin (HPSJ) Contracted Providers, Facilities, and Ancillary Services From: HPSJ Quality Management Department Subject: Important Information: HEDIS Tip Sheet, G0447 Business: Medi-Cal The annual HEDIS Provider Tip Sheet is a tool used to inform providers of the value set codes published at the national level […]

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Revised DHCS FSR/MRR tool

Date: June 28, 2019 To: Health Plan of San Joaquin (HPSJ) PCP sites and Facilities From: HPSJ Quality Management Department Subject: Revised DHCS FSR/MRR tool Business: Medi-Cal Managed Care Health Plan of San Joaquin (HPSJ) is charged with maintaining the quality of care for our members. Therefore, each of HPSJ’s contracted PCP sites is subject […]

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UPDATE – Recovery Payments – Non-Invasive Vascular Diagnostic Studies

Date: June 13, 2019 To: Health Plan of San Joaquin (HPSJ) Practitioners and Providers and Dialysis Clinics From: HPSJ Claims Departmen Subject: UPDATE – Recovery Payments – Non-Invasive Vascular Diagnostic Studies Business: Medi-Cal HPSJ recently identified a system issue which may have caused erroneous payments on specific codes for Non-Invasive Vascular Diagnostic Studies (NVDS). We […]

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Formulary Update effective 8/19/2019

Date: June 12, 2019 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: Health Plan of San Joaquin Pharmacy and Therapeutics Committee Subject: Formulary Update effective 8/19/2019 Business: Medi-Cal Effective 8/19/2019, the Pharmacy and Therapeutics Committee has approved the following changes:   Additions to the Formulary: Semaglutide (Ozempic) Pen Injector:  PA required.  […]

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Introducing Cactus Application Manager!

Date: June 4, 2019 To: Health Plan of San Joaquin (HPSJ) Practitioners, Providers and Facilities From: HPSJ Credentialing Department, Quality Improvement Subject: Electronic Credentialing – Application Manager Business: Medi-Cal Managed Care Introducing Cactus Application Manager! The Cactus Provider Management Platform is a robust and comprehensive software solution. It provides automated credentialing, quality improvement, and risk […]

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Stanislaus TB Clinic Information Update – And Resource for Future Assistance

Date: May 30, 2019 To: Health Plan of San Joaquin (HPSJ) Stanislaus County Practices & Providers From: HPSJ Medical Management Department Subject: Stanislaus TB Clinic Information Update – And Resource for Future Assistance Business: Medi-Cal Managed Care This message is to inform you of upcoming changes to clinical services provided at the Stanislaus County Health […]

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Risks with Sudden Discontinuation of Opioids

Date: May 30, 2019 To: HPSJ Primary Care Providers, Specialists, and Pharmacies From: HPSJ Medical Management Department Subject: Risks with Sudden Discontinuation of Opioids Business: Medi-Cal The Department of Health Care Services (DHCS) wants all providers to be aware of the Food and Drug Administration (FDA) announcement of April 9, 2019 regarding risks of sudden […]

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TRAINING OPPORTUNITY – Focus on Latent TB Prevention

Date: March 22, 2019 To: Health Plan of San Joaquin (HPSJ) – Stanislaus County Practices and Providers From: HPSJ Medical Management Department Subject: TRAINING OPPORTUNITY – Focus on Latent TB Prevention Business: Medi-Cal Managed Care “Registration Deadline: Friday, May 24, 2019 Register at – https://www.currytbcenter.ucsf.edu/trainings/focus-tb-prevention Wednesday June 5, 2019 there will be a half-day training […]

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Update in Grievance Process – Grievances and Grievance Replies

Date: May 16, 2019 To: Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP) From: HPSJ Quality Management Department Subject: Update in Grievance Process – Grievances and Grievance Replies Business: Medi-Cal Health Plan of San Joaquin (HPSJ) is charged with maintaining quality of care for our members and as such must investigate, or follow […]

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